RESULTS OF THE BEP PROTOCOL IN NONSEMINOMATOUS GERM-CELL TUMORS

Between 1993 and 1995, 27 patients with nonseminomatous germ cell testicular cancer followed by Gülhane Military Medical Academy, Department of Haematology-Oncology were included in this study. The mean age was 24.3 (17-31). Nine patients were in stage A (33%), 8 patients in stage B (29%), and 10 patients were stage C (38%). In histopathologic classification 14 patients (52%) had embryonal carcinoma, 9 (33%) teratocarcinoma and 4 (15%) mixed cellular carcinoma. BEP (Bleomycin, Etoposide, Cisplatin) regimen was given in 22 patients. Complete remission was achieved in 9 (50%) stage B and C patients who had a measurable radiologic lesion. Retroperitoneal lymph node dissection was applied to 7 (32%) patients who had normal tumour markers but residual disease in computerized tomography. Two of the 7 were mature teratoma, 1 was metastatic carcinoma and 4 were fibrosis. As a result complete remission was achieved in 15 out of 18 patients with stage B+C. Three patients relapsed in a mean 7 (4-11) months. Salvaged chemotherapy was applied to these cases as well as partial responders. Two of 6 cases who had relapsed and undergone salvage chemotherapy died of progressive disease. The maximum and median follow ups were 36 and 13.2 months respectively. The overall survival rate was 91%. Grade I-II myelosupression and alopecia were the frequent side effects.